Botox Injection on vocal cords - Open to All Other Health Topics Message Board

twest · 10-14-2004, 12:51 PM

My 76 yr old dad is considering botox injection to his vocal cords per his doctor's advise. He had the hic-ups for a few weeks non-stop and when the dr gave him a medication they finally stopped but he developed nodules on his vocal cords. They removed the nodules a couple of times but they grow right back. The dr says they can inject botox to his vocal cords to paralyze them and he will be unable to speak for 2-3 months. This will allow them to heal enough to keep the growths off. This sounds kinda weird to me. Anyone ever heard of this? If so, what are any complications that may arise. Thanks! Oh, forgot to mention that the dr thinks he has acid reflux which also worsens this condition. He doesn't have symptoms of acid reflux but did try medications for that as well with no relief from the nodules. He coughs alot and chokes when eating.

zuzu8 · 10-14-2004, 05:02 PM

Hmmm...tricky one.

Vocal-cord nodules are usually caused by vocal abuse "habits" — If you do nothing to change these habits, cord nodules can last a lifetime, and even can recur after surgical removal. Often, treatment requires modification of voice habits, and referral to a speech therapist may be a good idea.
Resting the vocal cords by allowing little or no speaking for several weeks may permit the nodules to shrink and/or resolve completely.

I would ask the doctor if he recommends speech therapy first. (Unless of course the nodules are a direct result of the hiccup spasms. HAS YOUR FATHER HAS LONG BOUTS OF HICCUPS BEFORE?)

I understand the theory behind botox injections, which is to prevent the use of the vocal cords (completely resting them), thus giving them a chance to "heal".
Botox is probably a "fast" way to achieve this but unless there is some voice re-training by a speech pathologist, (if that indeed is the main cause in your dad's case, and not the hiccup siege) it seems to me that after the Botox wears off, your father's problem might again recur. It won't solve the underlying reason why he developed the nodules in the first place.

The botox idea does make one a little queasy doesn't it? Ask the doc why NOT voice modification therapy first before something invasive like the injection of a TOXIN!?

zuzu xx

twest · 10-15-2004, 08:41 AM

Zuzu,

Thanks for the quick reply. My dad did go to speech therapy, but he didn't stick with it for very long. He thought it silly of course because he feels he speaks in a regular tone (which he does). He does seem to clear his throat alot because of the irritation. He has had several long bouts of the hic-cups over the last few years. On 10-27 they will remove the nodules and inject the Botox. I guess his only option would be to go back to speech therapy and try that again first. Have you ever heard of Acid Reflux causing such a condition?

zuzu8 · 10-15-2004, 11:27 AM

Twest,

You can have acid reflux without "typical" heartburn symptoms. Chronic cough, throat clearing, choking after food. And commonly, guess what else?... hiccups!

Even though vocal cord nodules (and polyps) develop mainly from abuse of the voice, any chronic irritation of the larynx, like smoking.... and absolutely yes- acid reflux, can also cause (or worsen) the situation.

After the surgery and Botox, if acid reflux is the true culprit that has been causing the recurrences and preventing total healing, I'm sure the doctor will prescribe the appropriate medication so that these nodules go away and stay away once and for all.

zuzu xx

twest · 10-15-2004, 12:51 PM

Zuzu,

Your response was very informative and sounds right on the mark. I appreciate your concern. Hopefully the surgery will give it time to heal and I will stress to my dad how important it is to take the meds for acid reflux. THANKS A BUNCH!